FDA Adverse Event Other Summary report: N

BIOGLUE SURGICAL ADHESIVE

MDR report key: 518147 · Received March 29, 2004

Report

Report Number
1063481-2004-00004
Event Type
Other
Date Received
March 29, 2004
Date of Event
January 9, 2004
Report Date
February 26, 2004
Manufacturer
CRYOLIFE, INC.
Product Code
MFI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

ACCORDING TO INFO PROVIDED BY THE USER FACILITY, A PT OF UNK AGE AND MEDICAL HISTORY UNDERWENT SURGERY OF UNKNOWN TYPE INCORPORATING THE USE OF BIOGLUE SURGICAL ADHESIVE IN THE POSTERIOR FOSSA REGION OF THE SKULL (NOT AN APPROVED USE IN THE UNITED STATES) IN 2003. AT APPROX 4 MONTHS POST SURGERY, THE PT REQUIRED ADDITIONAL SURGERY SECONDARY TO INFECTION ASSOCIATED WITH AN UNKNOWN PATHOGEN. THE PT SUBSEQUENTLY REQUIRED 3 ADDITIONAL DAYS IN THE HOSP FOR TREATMENT OF THE INFECTION. THE INFECTION HAS SUBSIDED AND THE PT IS CURRENTLY IN GOOD CONDITION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOGLUE SURGICAL ADHESIVE SURGICAL ADHESIVE MFI CRYOLIFE, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Hospitalization| R NOT AVAILABLE